EAST ORANGE MEDICAL PRACTICE
NPI 1114116175
Internal Medicine in East Orange, NJ
About East Orange Medical Practice NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EAST ORANGE MEDICAL PRACTICE (NPI 1114116175) is a healthcare organization registered as an internal medicine in East Orange, New Jersey and active in the NPI registry since October 2007. The organization lists Robert A Clarke, Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
East Orange Medical Practice is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to East Orange Medical Practice, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is East Orange Medical Practice's NPI number?
The NPI number for East Orange Medical Practice is 1114116175. It was assigned to this organization in the NPPES registry on October 16, 2007.
Where is East Orange Medical Practice located?
East Orange Medical Practice is located at 108 S Munn Ave, East Orange, NJ 07018. The listed phone number is (973) 674-8100.
What is East Orange Medical Practice's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is East Orange Medical Practice enrolled in Medicare?
Yes. East Orange Medical Practice is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through East Orange Medical Practice?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to East Orange Medical Practice. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for East Orange Medical Practice was last updated on October 16, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# East Orange Medical Practice · NPI 1114116175
Internal Medicine organization in East Orange, New Jersey. Organization record, active in the CMS NPPES registry since October 16, 2007.
## Identity
- **NPI:** 1114116175 (Entity type: Organization)
- **Enumerated:** October 16, 2007
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Robert Clarke, DIRECTOR
## Practice location
- **Address:** 108 S MUNN AVE, East Orange, NJ 07018-3402
- **Phone:** (973) 674-8100 · **Fax:** (973) 674-8400
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 16, 2007
- **Other identifiers:** Medicare PIN 100425 (NJ)
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Source: [NPI Profile](https://npiprofile.com/npi/1114116175) · Data from the CMS NPPES public registry.